Many people believe once they pass beyond their teen years, they no longer need vaccination shots. This, though, goes against conventional medical wisdom. As an adult, recommendations for inoculation are based upon a person’s age, travel plans, lifestyle, previous history of immunization, and whether or not any high-risk conditions, such as a particularly nasty flu, exist. This past September, the National Vaccine Advisory Committee approved and updated its standards for adult immunizations. On Tuesday, the Advisory Committee on Immunization Practices (ACIP) published in Annals of Internal Medicine its own review of the Adult Immunization Schedule.

What is ACIP? This group of 15 medical and public health experts develops recommendations on how to use vaccines to control diseases in the U.S. One member is a consumer representative who provides perspectives on the social and community aspects of vaccination, while 14 members work in the fields of vaccinology, immunology, pediatrics, internal medicine, nursing, family medicine, virology, public health, infectious diseases, and/or preventive medicine. In its review of recommendations, ACIP not only reviews standard protocols but also acknowledges the current low levels of vaccination coverage among adults.

ACIP concedes, for instance, that the general public seems to have a limited awareness about vaccines for adults and because of this, knowledge gaps should be addressed during routine medical examinations. Specifically, ACIP proposes health care providers play a larger role in ensuring their patients are up-to-date on recommended vaccines. “A recommendation by a patient's provider for needed vaccines is a strong predictor of patients receiving recommended vaccines,” the authors writing on behalf of ACIP noted in their published report. Ideally, providers would assess the vaccination needs of patients at the time of each visit; recommend any needed vaccines; and then offer the vaccine or refer the patient to a provider.

Another issue raised by the authors is documentation and record-keeping. Adult patients, unlike children, often consult more than one health care provider, plus they are often offered vaccinations at work, local pharmacies, and other locations. Because of this, documentation in immunization information systems (vaccine registries) may be incomplete; for many adults, then, their entire vaccination histories are unavailable or inaccessible to all of their medical providers. Better record-keeping is necessary to make some situations easier, such as cases where adults require more than one dose or when time intervals elapse between doses (the hepatitis B vaccine, for example, is offered in a three-dose series). Looking ahead, this problem may be alleviated with the adoption of Electronic Medical Records (EMRs), as outlined in the American Recovery and Reinvestment Act. This law will require more than 70 percent of primary care providers to implement EMRs by October. For many people, then, their complete health care records, including a vaccination history, will soon be accessible by all their doctors. No need to wait until October, though. Why not review the Adult Vaccination Schedule and decide with your doctor's help whether or not you wish to comply.

Source: Bridges CB, Coyne-Beasley T on behalf of ACIP. Advisory Committee on Immunization Practices Recommended Immunization Schedule for Adults Aged 19 Years or Older: United States, 2014. Annals of Internal Medicine. 2014.